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Multisystemic Therapy (MST) for juvenile offenders

Health Factors: Community Safety
Decision Makers: Local Government State Government Federal Government Healthcare Professionals & Advocates Nonprofit Leaders
Evidence Rating: Scientifically Supported
Population Reach: <1% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Multisystemic Therapy (MST) is an intensive, family- and community-based intervention for serious juvenile offenders. The intervention focuses on individual, family, peer, school, and community factors that contribute to juvenile antisocial behaviors. MST requires concrete, measurable efforts from youth and families, occurs in settings such as homes or schools, and typically lasts several hours per week for three to five months. The program builds on strengths in youths’ lives while altering problematic interactions with family and peers (PPN). Recently, adaptations of MST have been applied to child health and psychiatric problems, youth substance abuse, problem sexual behavior, and child abuse and neglect (MST).

Expected Beneficial Outcomes

Reduced recidivism
Reduced incarceration
Improved family functioning
Reduced delinquent behavior
Reduced substance abuse

Evidence of Effectiveness

There is strong evidence that Multisystemic Therapy (MST) for juvenile offenders reduces the likelihood of recidivism and incarceration, and increases family functioning for participating youth (SAMHSA-NREPP, Stouwe 2014, Zajac 2015, PPN). MST can also reduce delinquent behavior and alcohol and drug use among juvenile offenders (PPN, SAMHSA-NREPP, Stouwe 2014, Zajac 2015, Baldwin 2012).

Research suggests that MST can improve participating youths’ behavioral and emotional problem behavior and functioning at school, work, and home (PPN, Stouwe 2014), as well as their peer relations (PPN, SAMHSA-NREPP, Stouwe 2014). MST may also decrease delinquent behavior, sexual behavior problems, incarceration, and residential treatment for youth charged with sexual offenses (Letourneau 2009, Letourneau 2013b). The program may reduce arrest and incarceration, and increase probation completion among Hispanic youth offenders (RAND-Fain 2014). A 25-year follow-up evaluation of siblings of MST participants indicates decreases in arrest, probation, and incarceration among children whose siblings participated in MST (Wagner 2014).

A version of MST for families of abused and neglected children has been shown to improve children’s and caregivers’ mental health and reduce the likelihood that caregivers will neglect or assault their children (Swenson 2010, Pane 2013). MST for mentally ill or disturbed youth may reduce poor behavior, suicide attempts, and out of home placements while improving family functioning (Pane 2013). Adaptations of MST have also been linked to better metabolic control and reduced hospital admissions for youth with poorly controlled diabetes, weight loss in overweight youth (Pane 2013), and reduced viral load for youth HIV taking retroviral medication (Letourneau 2013).

A study estimates that MST for juvenile offenders has greater cumulative societal benefits than individual therapy (Dopp 2014). A Washington-based analysis estimates that MST cost about $7,700 per juvenile offender in 2012, with a benefit to cost ratio of $1.74 (WSIPP-Benefit cost).

Implementation

United States

Thirty-four states have licensed MST providers (MST).

Wisconsin

Wisconsin’s teams of MST providers work through St Croix County’s department of health and human services and Lutheran Social Services of Wisconsin and Upper Michigan (MST).

Implementation Resources

MST - Multisystemic Therapy (MST). Breaking the cycle of criminal behavior by keeping teens at home, in school and out of trouble. Accessed on February 29, 2016

Citations - Description

MST - Multisystemic Therapy (MST). Breaking the cycle of criminal behavior by keeping teens at home, in school and out of trouble. Accessed on February 29, 2016
PPN - Promising Practices Network (PPN). On children, families and communities. Accessed on December 7, 2016

Citations - Evidence

Baldwin 2012* - Baldwin SA, Christian S, Berkeljon A, Shadish WR, Bean R. The effects of family therapies for adolescent delinquency and substance abuse: A meta-analysis. Journal of Marital & Family Therapy. 2012;38(1):281-304. Accessed on November 30, 2015
Dopp 2014* - Dopp AR, Borduin CM, Wagner DV, Sawyer AM. The economic impact of multisystemic therapy through midlife: A cost-benefit analysis with serious juvenile offenders and their siblings. Journal of Consulting and Clinical Psychology. 2014;82(4):694–705. Accessed on June 30, 2016
Letourneau 2009 - Letourneau EJ, Henggeler SW, Borduin CM, et al. Multisystemic therapy for juvenile sexual offenders: 1-Year results from a randomized effectiveness trial. Journal of Family Psychology. 2009;23(1):89-102. Accessed on March 14, 2016
Letourneau 2013* - Letourneau EJ, Ellis DA, Naar-King S, et al. Multisystemic therapy for poorly adherent youth with HIV: Results from a pilot randomized controlled trial. AIDS Care. 2013;25(4):507–14. Accessed on July 1, 2016
Letourneau 2013b* - Letourneau EJ, Henggeler SW, McCart MR, et al. Two-year follow-up of a randomized effectiveness trial evaluating MST for juveniles who sexually offend. Journal of Family Psychology. 2013;27(6):978–985. Accessed on June 30, 2016
Pane 2013* - Pane HT, White RS, Nadorff MR, Grills-Taquechel A, Stanley MA. Multisystemic therapy for child non-externalizing psychological and health problems: A preliminary review. Clinical Child and Family Psychology Review. 2013;16(1):81–99. Accessed on May 20, 2016
PPN - Promising Practices Network (PPN). On children, families and communities. Accessed on December 7, 2016
RAND-Fain 2014 - Fain T, Greathouse SM, Turner S, Weinberg HD. Is multisystemic therapy (MST) effective for Hispanic youth? An evaluation of outcomes for juvenile offenders in Los Angeles County. Santa Monica, CA: RAND Corporation; 2014. Accessed on June 30, 2016
SAMHSA-NREPP - SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP). Accessed on November 17, 2017
Stouwe 2014* - van der Stouwe T, Asscher JJ, Stams GJJM, Dekovi? M, van der Laan PH. The effectiveness of Multisystemic Therapy (MST): A meta-analysis. Clinical Psychology Review. 2014;34(6):468–481. Accessed on June 30, 2016
Swenson 2010 - Swenson CC, Schaeffer CM, Henggeler SW, Faldowski R, Mayhew AM. Multisystemic therapy for child abuse and neglect: A randomized effectiveness trial. Journal of Family Psychology. 2010;24(4):497-507. Accessed on November 9, 2015
Wagner 2014* - Wagner DV, Borduin CM, Sawyer AM, Dopp AR. Long-term prevention of criminality in siblings of serious and violent juvenile offenders: A 25-year follow-up to a randomized clinical trial of multisystemic therapy. Journal of Consulting and Clinical Psychology. 2014;82(3):492–499. Accessed on June 30, 2016
WSIPP-Benefit cost - Washington State Institute for Public Policy (WSIPP). Benefit-cost results. Accessed on September 28, 2017
Zajac 2015* - Zajac K, Randall J, Swenson CC. Multisystemic therapy for externalizing youth. Child and Adolescent Psychiatric Clinics of North America. 2015;24(3):601–616. Accessed on June 30, 2016

Citations - Implementation

MST - Multisystemic Therapy (MST). Breaking the cycle of criminal behavior by keeping teens at home, in school and out of trouble. Accessed on February 29, 2016

Page Last Updated

June 29, 2016

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